Rugby Finger

SYMPTOMS

There is localised exercise-induced pain and inability to flex the DIP or PIP joint of the third finger.

AETIOLOGY

These symptoms are caused by rupture of the volar plate with or without avulsion of a bony fragment or the flexor tendon insertion. It occurs when the finger is hyper-extended by force during an attempt to flex.

CLINICAL FINDINGS

There is localised tenderness on palpation over the DIP or PIP joint of the ring finger and inability to flex the joints against resistance.

INVESTIGATIONS

X-ray may show an avulsed bony fragment.

TREATMENT

A stabilising bandage, brace or strapping should be applied. Surgery for repair of the volar plate is usually required followed by six weeks’ immobilisation of the finger and physiotherapy.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon and hand specialist if the pain is severe or if the
diagnosis is not clear.

EXERCISE PRESCRIPTION

Most sports can be maintained during healing. After surgery the symptoms are usually relieved almost immediately and most activities can be back to normal within six weeks. Running, cycling and water exercises (when the wound is healed after surgery) are good alternatives to keep up general fitness. Gym training can be maintained.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs and good hand function. Compare with other hand.

DIFFERENTIAL DIAGNOSES

This is a clear clinical diagnosis, verified by X-ray.

PROGNOSIS

Excellent, if treated appropriately. If it is missed, surgery can be performed at a later stage.